How drug checks at festivals could save lives

It happens in Europe, the UK and Australia - why aren't we doing it in NZ?

Photo: Illustration: Rachel Neser

In the early 2000s, a 20-year-old woman was raced to the emergency department of an Adelaide hospital. Less than two hours earlier, she had taken a blue pill she thought was ecstasy. Now she was having violent seizures.

Doctors described her state in the pages of a medical journal: Pupils 6mm in diameter, teeth clenched with blood in her mouth and heart racing at an alarming 169 beats per minute. Her relentless fits made it impossible for medics to get an airway tube into her throat.

The young woman was suffering an overdose from para-methoxyamphetamine or PMA – a drug similar to MDMA (the chemical in ecstasy) that can make you feel alert and full of energy. However, PMA is more poisonous and can kill at much lower doses than MDMA. On the drug market, it’s known as Dr Death.

PMA was linked to 11 fatalities between 1995 and 2001 in South Australia and at least 27 in Britain in 2012. Many victims had no idea they were taking it, thinking it was MDMA or ecstasy. Last year, the Dr Death showed up in ecstasy pills in New Zealand.

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Dr David Caldicott co-authored the medical journal report on the young woman in Adelaide. The lecturer, researcher and emergency consultant at Canberra's Calvary Hospital remembers the wave of young people in his emergency room with serious Dr Death complications. He also remembers one he couldn’t save.

“This is a guy who died on my watch. Most emergency folk will know, it’s a big deal for a young person to die like that. You don’t let people go like that.”

Moved by the death, Caldicott has become a fierce advocate for drug-checking. The practice is already well-established in Europe but is yet to get started in this part of the world.

He believes what he’s advocating for makes complete, unquestionable sense - give people a chance to have their drugs tested, tell them exactly what’s in them so they can make informed decisions on what to do. Music and dance festivals have proved to be the perfect place to offer free drug-checking to experimental young people, potentially saving their lives.

But despite the logic, he faces stiff opposition.

“The classic line we’re faced with always is that it ‘sends the wrong message’. The problem is, we never designed the right message to start with,” says Caldicott. Prohibitive drug policies, tough laws and an ongoing “war on drugs” means the main thing young people hear concerning drugs is: Just Don’t Do It.

“You can’t tell a group of young people who are already doing what young people do that they can’t do it anymore because they’re being naughty. That won’t change behaviour.”

“These are not four-year-olds. These are university graduates who are successfully using drugs without getting hurt. The problem is, the market is volatile. In fact, the reasons to do this are twice as many as when I first started.”

The worldwide drug scene is more dangerous than it’s ever been. This is not a hyperbole, insists Dr Caldicott, but a cold, hard fact. At least two new psychoactive substances were detected in the Europe per week last year and these drugs are filtering their way down to New Zealand through the dark web.

“We’re seeing multiple reiterations of bizarre drugs which many of us, including major nerds like me, have never seen before.”

After working on papers about the deadly strain of PMA, Caldicott realised there was one way to stop people from putting deadly drugs into their mouths: Tell people what was in them.

“The thing that we now know about millennials is that it’s all about them. If you want to affect the behaviour of a millennial, you need to basically make it all about them. And what better way than to personalise the message about the drugs that they’re consuming?”

Caldicott has been campaigning hard for free drug-checking to be introduced to music festivals in New Zealand and visited with politicians, police and the NZ Drug Foundation earlier this year.

Five young people died from overdoses at music festivals in Australia last year and it’s only a matter of time before it happens here, he says.

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Dr Paul Quigley, an emergency medicine specialist and clinical toxicologist at Wellington Hospital, has been working in the area of drug-checking for about 16 years.

“No matter how many times we’ve told people not to [take drugs], they’re still doing it. New Zealand remains one of the highest recreational pill using countries in the world per head of population,” he says.

“Figures quote that one in five New Zealanders between the ages of 16 and 25 have tried an illicit pill at some stage…one in five!”

There have been pockets of “underground testing” done at New Zealand music festivals over the last few years that have produced strong results, says Dr Quigley.

“They’re showing that first of all, consumers are willing to put their pill up and even though that pill cost them $40 or $50 when the result is a bad result, they’ve thrown that pill away.”

This is the time of year that New Zealand should be implementing drug-checking with festivals and parties just around the corner. But, the reality is, things in health and politics move very slowly he says.

New Zealand is already two-and-a-half decades behind parts of Europe that have been drug-checking since the early ‘90s. It also happens in parts of the UK and Australia.

This seems particularly odd to Dr Caldicott. He says New Zealand has been considered a world-leader in drug policy and approach and can’t understand why we haven’t cottoned on to this yet.

“New Zealand has been prepared to think outside the box. The bizarre thing is, this isn’t even outside the box anymore … this is really low-hanging fruit.”

As far as Caldicott is concerned, there is no sensible argument against drug-checking. In his own team’s on-site labs from the early 2000s, as many as two-thirds of those surveyed wouldn’t take their drugs if they found them to contain something other than what they were expecting.

“Drug use is an issue of safety. It’s to do with health. It’s to do with not being killed.”

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In 2014, Hollie* and a group of her friends made the trip to a three-day music festival.

She and everyone she was there with bought MDMA pills from a guy selling various drugs on-site.

“It had been a really nice day and it was getting towards night time, so me and a few friends I was camping with took our pill at the same time.”

This wasn’t the first time Hollie has taken drugs. She knew a good and bad trip can have as much to do with headspace you’re in as the drug itself, but nothing suggested something was about to go wrong.

“I was having a really good time, really nice chill day, and I wasn’t even particularly drunk,” but one or two songs into the set Hollie was watching and she began to freak out.

“I could see everything all at once. My brain wasn’t filtering.”

Hollie could see every blink in the room simultaneously, the beads of sweat dripping down faces in slow motion. It was grotesque, overwhelming and she felt non-human, “like a cyborg”.

She ended up in the merchandise room with her back firmly pressed against the wall, hoping for the drugs to wear off quickly. Paranoia gripped her and she was worried it wouldn’t ever end.

Photo: Illustration: Rachel Neser

The confusing part was, no one else she spoke to seemed to share her experience. “Everybody else had a really good time. I talked to a lot of people about it and they said ‘oh it was fine for me’.”

The 29-year-old won’t ever know what was in the pill or why she reacted the way she did but says she would have gotten the pill tested if facilities were available on site.

“If I had found out it wasn’t MDMA, I probably wouldn’t have taken it. I’m usually pretty cautious. But if the test said it was MDMA and I took it, I would’ve had the same response anyway so I don’t know if it would’ve helped.”

“It’s just an idea that makes sense. We have a drug policy that is based on innovation, compassion and proportion as its core principle and I think this is consistent which each of those approaches. We’re also talking about treating drugs primarily as a health issue, not a criminal justice issue.”

Dunne is well aware prohibitive drug campaigns don’t stop young people experimenting. Limiting the supply into New Zealand is a stronger measure, he says.

“I worked in the alcohol and drug field in the 1970s and the approach then was ‘don’t talk about the forbidden fruit because you go back to Adam and Eve’ and all the forbidden fruit arguments. All it does is encourage experimentation. Nothing has changed.”

But that leaves a gaping question about why isn’t it already happening.

“To be perfectly honest, I think the reason is that it’s just a little bit difficult in the sense that we have a law that prohibits the use of illicit drugs,” says Dunne.

While the general feeling is that drug-checking a brilliant idea, it doesn’t quite match up with a law that says you shouldn’t have those drugs in the first place. However, other countries are successfully doing so Dunne says he’s ready to start a real conversation that could see pill testing introduced.

“All of the discussion to date have been quite informal. Everyone is one the same page so what we probably need is an approach from the Drug Foundation or a festival organiser or someone to say ‘look, how can we actually do this?”

Photo: Mava Enoka / The Wireless

Festival organisers are reluctant to talk about the issue and at least three turned down interview requests. But John Minty, Splore Festival Organiser stepped outside of the pack. Although he considers Splore a “family festival” without a high number of drug users, he’s “not naive” about people bringing pills onsite.

“I think from all festival owners’ point of view, I don’t think anyone would have an objection to increasing the health and safety. Last thing you want is someone overdosing at your festival.”

Minty says resource consent requires organisers to search for drugs before people enter the festival and that the drugs must be confiscated. Setting up a drug-checking tent not only sends mixed messages, but could also leave festival goers and organisers open to legal action.

“Drugs have always been quite problematic in terms of enforcement. Most festivals have had police attend at certain stages and there’s extensive searching before punters come onto the site.”

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Minty says he and other organisers would need assurance from police and local bodies that no one would be penalised, but New Zealand law enforcement is not stepping up to the plate just yet. Police turned down our request for an interview, offering a statement from a spokesperson instead:

“The use of drug-checking kits is a matter for event organisers to consider. However, Police will continue to maintain an appropriate presence at these types of events to ensure people have a good time safely. Police will respond appropriately to any drug or alcohol-related harm which occurs at these types of events.”

It’s a vague and non-reassuring stance that seems to pass the buck on to the organisers to make the first move. At the moment, New Zealand seems to be involved in a perpetual game of pass the parcel, just waiting for someone to take responsibility.

Dr Caldicott says he has spoken to health professionals who would be “more than happy” to volunteer time to test drugs at festivals, researchers who would find the data collected invaluable, and even people at Auckland University who could supply the equipment.

[image:174016:full] “We’re seeing multiple reiterations of bizarre drugs which many of us have never seen before” - Dr Caldicott

“It is very easy to deploy the equipment needed to do this …This is not super-duper space kit that belongs in a Marvel comic; these are the sorts of kits that are deployed at all of your border crossings.”

Despite the support drug-checking has garnered, it doesn’t look like enough formal measures will be put in place in time for it to kick off this festival season. With a drug scene presenting users with ultra-high purity pills and unknown combinations of chemicals, that may be a lag New Zealand will look back on and regret.

“Every time someone gets hurt or someone dies, the people who oppose this initiative have an extra little bit of blood on their hands. It is absolutely on their hands because we truly believe that we can alter the way young people use drugs,” says Caldicott.